247www.expert-reviews.com ISSN 1747-4108© 2011 Expert Reviews Ltd

Meeting Report

10.1586/EOG.11.22

Unzila Nayeri†1 and Catalin S Buhimschi11Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University, 333 Cedar Street, New Haven, CT 06510-3218, USA †Author for correspondence:Tel.: +1 203 785 3091 Fax: +1 203 737 2327 unzila.ali@yale.edu

Society for Maternal–Fetal Medicine’s 31st Annual Meeting: The Pregnancy Meeting San Francisco, CA, USA, 7–12 February 2011

The annual meeting for the Society of Maternal–Fetal Medicine (SMFM) was held in San Francisco, CA, USA, on 7–12 February 2011. With over 2000 people in attendance, the meeting presented innovative basic science, clinical and epidemiological research. Under the leadership of Joshua Copel (Yale University School of Medicine, CT, USA), President of SMFM, and Alfred Abuhamad (Eastern Virgina Medical School, VA, USA), SMFM Program Chair, the meeting encompassed a wide variety of postgraduate courses, oral and poster sessions, and round-table luncheon presentations with world-renowned speakers.

31st Annual Meeting of the Society for Maternal–Fetal MedicineExpert Rev. Obstet. Gynecol. 6(3), 247–249 (2011)

Branch, TX, USA) was held for the very first time and will continue to convene at future Society for Maternal–Fetal Medicine (SMFM) annual meetings. Maternal–fetal intervention-ists provided updates on innovations in mater-nal–fetal surgery such as treatment of congenital diaphragmatic hernia and spina bifida. These forums provided the opportunity for small-group discussion on exciting advances in the field of MFM.

Following completion of the courses, the conference opened with a plenary session that spanned a spectrum of topics. Speakers pre-sented research on methods of induction of labor. Marta Jozwiak (Groen Hart Hospital, The Netherlands) demonstrated that a Foley catheter was equally effective when compared with induc-tion with prostaglandins and was associated with less morbidity. George Macones (Washington University, MO, USA) also presented his research on labor induction. Specifically, his work revealed that early amniotomy in nul-liparous labor inductions decreased the time to delivery by at least 20% and increased the like-lihood of delivery within 24 h. Antonio Frias (Oregon Health and Science University, OR, USA) presented research demonstrating that maternal high-fat diets decreased uterine artery volume blood flow resulting in an increased fre-quency of stillbirth. The group proposed that

The 31st Annual Meeting began with ten informative postgraduate courses that were held between 7 and 9 February 2011. Courses spanned a wide spectrum of subjects and included topics on basic science and translational research, ultrasound, fetal echocardiography, genetics, global health, obesity, critical care and maternal medical complications. ‘Debates on Controversial Obstetric Management’ was one of the most popular courses. Topics for debate included indications for cerclage, magnesium sulfate for neuro protection and diagnostic crite-ria for gestational diabetes. Experts in maternal–fetal medicine (MFM) debated these various subjects and, via an audience response system at the end of the discussion, attendees were polled on their opinions and any potential changes in clinical practice patterns. For the first time this year, participants were given an electronic sylla-bus. Attendees enjoyed the wide array of subjects and discussions.

On the evening of 9 February 2011, scientific forums were held to discuss novel diagnostic methods, treatments and approaches in MFM. These intimate scientific forums included dis-cussions on hypertension, infections in preg-nancy, maternal–fetal surgery, preterm labor and perinatal epidemiology. A forum entitled ‘Pregnancy as a Window to Future Health’, led by George Saade (University of Texas Medical

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poor nutrition during pregnancy, in addition to obesity itself, serves as a risk factor for adverse obstetric outcomes. Frias won an award for his presentation.

The first oral plenary session was followed by three oral con-current sessions. The three sessions covered topics in prema-turity, hypertension/physiology and clinical obstetrics. Lydia Shook, a medical student (Yale University School of Medicine, CT, USA), presented novel research on nanoparticles in human amniotic fluid as a cause of idiopathic preterm birth and preterm premature rupture of membranes. Andrew Coombs (California Obstetrics Medical Group, CA, USA) demonstrated that pro-phylactic 17-hydroxyprogesterone was not effective in reducing the rate of preterm delivery or neonatal morbidity via a placebo-controlled double-blind multicenter randomized clinical trial. The role of anti-IL-6 receptor antagonists for the prevention of fetal long-term neurological sequelae was tested in a rat model of lipopolysaccharide-induced maternal inflammation by Justine Ouellet (University of Sherbrooke, QC, Canada). The results of this study were provocative given that blockage of the inflamma-tory cascade by the IL-6 receptor antagonist increased maternal and neonatal morbidity. This study provided evidence that the balance between physiological and pathological inflammation is critical for fetal physiology and development. The March of Dimes Award for Best Research in Prematurity was awarded to Yuguang Wang (Herbin Medical Center, Herbin, China). Errol Norwitz presented the work. This research offered an explanation to the mechanism by which progesterone supplementation may prevent preterm delivery and demonstrated the possible role of progesterone on basal apoptosis.

Irina Buhimschi (Yale University) presented on the soluble receptor for advanced glycation end products (sRAGE) in severe preeclampsia. A key finding of the aforementioned report was that transcription of RAGE mRNA is important in modulating the activity of the RAGE pathway in preeclampsia. This study received the Excellence Research Award for the session.

The oral concurrent session on ‘Clinical Obstetrics’ covered a vast array of topics, ranging from shoulder dystocia to uterine atony. Moon Grady (University of California, San, CA, USA) was recognized for her research that demonstrated that diastolic pathology including tricuspid inflow and left ventricular isovolu-mic relaxation time were predictive of those monochorionic twin pregnancies at risk of developing twin–twin transfusion syndrome.

The ‘Fellows’ Plenary Session’ was held on the morning of 9 February 2011. Fellows presented novel clinical, translational and basic science research. Two fellows presented on the topic of group B streptococcus (GBS). Karishma Rai (University of Iowa Hospitals and Clinics, IA, USA) described a novel GBS vaccine using a murine model, while Brett Young (Massachusetts General Hospital/Harvard Medical School, MA, USA) illustrated an intra-partum rapid GBS test that would aim to improve the detection rate of intrapartum GBS colonization. By testing the concentrations of cefazolin within myometrium and adipose tissue, Leo Pevzner (University of California Irvine Medical Center, CA, USA )con-cluded that current preoperative antibiotic dosing regimens may fail to provide adequate coverage in obese patients. Christine Laky (Yale

University) discussed the involvement of the RAGE pathway in intrauterine growth restriction. Finally, Nathan Drever (University of Texas Medical Branch) was given the award for the best presenta-tion on his work on the effect of prenatal alcohol on antioxidant enzyme expression in a mouse model of fetal alcohol syndrome.

The afternoon of 11 February 2011 consisted of another round of oral concurrent sessions. Karin Fox (University of Texas Medical Branch in Galveston) presented her work on fetal programming of atherosclerosis. She cross-fostered mice with a genetic predisposi-tion towards hypercholesterolemia to mothers with the opposite genetic status. She determined that cholesterol levels in the off-spring with genetic hyperlipidemia declined postnatally but were persistently higher than in the control groups. Fox concluded that the postnatal environment is necessary but not sufficient to the developmental programming of hypercholesterolemia.

The final oral concurrent session was held on the morning of 12 February 2011. Multiple presentations focused on intra-partum fetal assessment. Sean Blackwell (University of Texas Health Science Center, TX, USA) presented his work evaluat-ing the reliability of the new 3-Tier Electronic Fetal Monitoring classification system. In his study, MFM specialists were asked to review various fetal heart rate tracings from women with term, singleton pregnancies with known umbilical artery pH results. They were asked to classify the tracings by National Institute of Child Health and Human Development (NICHD) category I, II or III. Each reviewer evaluated over 150 fetal heart rate segments. Blackwell found that interobserver agreement was poor for the various NICHD category assignments. His findings challenged the new management guidelines by the NICHD and led to an involved discussion questioning the new system.

Data from the Consortium on Safe Labor were presented by Michelle Kominiarek (University of Illinois, IL, USA). Reviewing electronic medical records of over 118,000 gravid women across the USA with known BMIs at admission, her group gathered data on labor patterns by BMI. They found that with an increas-ing BMI, diabetes, induction of labor and cesarean deliveries increased. Labor also proceeded more slowly with increasing BMI levels. This effect was more pronounced in nulliparous women. Kominiarek proposed that these differences should be taken into account when managing labor in patients of various BMIs.

In addition to the thought-provoking oral presentations, the conference featured over 800 poster presentations. Electronic posters were a new addition to this year’s meeting. A poster by Judette Louis (Case Western Reserve University, OH, USA) described the correlation between obstructive sleep apnea, sleep duration and proinflammatory cytokines. In a cohort of approxi-mately 100 obese pregnant women who underwent comprehensive sleep studies, Louis found that short sleep duration was not only prevalent, but also associated with an increase in proinflammatory cytokines, suggesting that disturbed sleep patterns in pregnancy may be associated with immune dysfunction.

John Owen (University of Alabama, AL, USA) presented his poster titled ‘Can the optimal cervical length for placing ultra-sound-indicated cerclage be identified?’ Conducting a secondary analysis of the NICHD-sponsored cerclage trial, Owen calculated

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Meeting Report

odds ratios and confidence intervals at various cervical lengths at randomization at gestational age cut-offs of less than 24, 32 and 35 weeks. He determined that for reducing preterm birth at all of these gestational age cut-offs, a cervical length of 15 mm was the apparent lower limit of action threshold. For specifically reducing preterm delivery at less than 35 weeks, cerclage efficacy was appreciated at all evaluated cervical lengths.

In addition to the oral and poster sessions, the 31st Annual Pregnancy Meeting featured a multitude of Masters’ Series Luncheon Roundtable discussions, which were held by experts in the respective fields. Beryl Benacerraf (Harvard Medical School, MA, USA) held a roundtable on ‘The Genetic Sonogram: Where Does it Fit in Down Syndrome Risk Assessment?’ Larry Platt (Center for Fetal Medicine and Women’s Ultrasound, CA, USA) discussed ‘3D Ultrasound in Obstetrics: Tricks of the Trade’.

The conference was more than a display of the innovative research and advances in the field of MFM. MFM specialists from all over the country were able to socialize and discuss their

research and experiences on a personal level. On the evening of 10 February 2011, there was a reception for MFM fellows in training. This was an opportunity for the fellows to mingle with their colleagues, exchange training experiences and share future goals and endeavors. A special reunion was held for the fellowship class of 2013; a tribute to their retreat in October 2010.

Next year’s 32nd Annual Pregnancy Meeting will be held in Dallas, Texas, USA, at the Hyatt Dallas Regency Hotel from 6 to 11 February 2012.

Financial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

31st Annual Meeting of the Society for Maternal–Fetal Medicine

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